Pain after Microdiscectomy

Tagged: Symptoms after a microdiscectomy

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brodydog
Participant

March 29, 2016 at 6:11 am

Post count: 12

#21774

Thank you for your answer. I started doing Yoga 4 weeks ago and that does seem to help. I do realize I keep my weight on my left side and that must be from the scolisios I have? That is what could be causing my tightness/ sciatica on my left side?? Very tight IT band and tightness feeling on the outside of my left knee. I do try and stretch every day which is good. I guess all I can do is keep exercising/stretching to strengthen my left side and try to equal out my stance/weight so that I am not putting it al on my left side. I am starting another round of PT today so hopefully that will be a good thing.

Maybe because I was away in late Nov. early December and played golf for 7 straight days that all of the swinging and walking I did caught up with me plus I played many times in all of December due to having good weather in our area so because of my Scoliosis – a lot of walking and playing golf(swinging) could have really aggraviated my situation?? Shame that walking a lot is a negative for me?? THX again !

brodydog
Participant

March 29, 2016 at 6:22 am

Post count: 12

#21775

Dr. Corenman- I meant to ask you-based on the MRI verbiage I posted to you- where do you think the most effective place on my back/spine area for a cortisone shot / facet or transformanial epidural would be most effective to stop my lower back pain?? As I stated before -I have had L4/ L5 cortisone shots also QL Muscle shots and neither have helped. My spine Dr. M -Quincy, Ma. is thinking of trying a facet or tranformanial epidural injection.

Thank You !

Donald Corenman, MD, DC
Moderator

March 29, 2016 at 9:04 pm

Post count: 8660

#21786

The MRI report of a degenerative scoliosis is typically never as accurate as it needs to be as the radiologist really is looking at film without hearing of the patient’s symptoms first-hand. Your symptoms of “tightness” (“tightness/ sciatica on my left side?? Very tight IT band and tightness feeling on the outside of my left knee) could be from nerve root irritation but the radiologist only noted right sided nerve compression. Typically with a scoliosis, there is the upper curve (on the right in your case) with upper root compression and the lower opposite curve (in your case, probably at the left L4-S1 level) with opposite root compression. This is what I would suspect but this is only a guess without radiological confirmation of this fact.

An epidural injection at L4-5 on the left might be helpful but this is an educated guess. Remember that if the pain is from a degenerative disc (or facet), the epidurals are only limited in their effectiveness.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

brodydog
Participant

March 30, 2016 at 10:38 am

Post count: 12

#21793

Hi Dr. Corenman- The 2 series of cortisone shots I had in my L4 & L5 8 weeks a go did not work to relieve any pain in my lower back or my left side(Siatica) Is this Transformial Epidural that you said might be helpful- is this DIFFERENT than the L4 and L5 shots I have already received. I went to PT yesterday and the person worked on my left leg/thigh in that he was getting a really good stretch out of that area and it did seem to loosen up that tightness feeling that I have. He had me lay on my right side with my right leg bent towards me and he was working on my left leg,thigh/pelvic to get that huge stretch. Is it possible that my issue his muscular?? Thank You!!

Donald Corenman, MD, DC
Moderator

March 31, 2016 at 2:26 am

Post count: 8660

#21806

The two injections you obtained at L4-5 could have been epidurals or facet blocks. These are widely different injections so you need to know what was given to you (https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic/, https://neckandback.com/treatments/facet-blocks-and-rhizotomies/).

Did you obtain any relief in the first 2-3 hours? Commonly, the injectionist will not tell you to aggravate or keep track of symptoms but the first 3 hours is the diagnostic window. Improvement in this period does tend to confirm the area injected can be the pain generator. Disc generated pain however will not respond to these injections and a different test (a discogram-only a pre surgical test) would be necessary.

“Muscular pain” can occur solely from muscle pathology but commonly, referral pain is spine (disc or facet) originating or nerve compression originating.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

brodydog
Participant

March 31, 2016 at 5:54 am

Post count: 12

#21809

I will have to ask Dr. M. about what I received in the first 2 series of shots. Just about 100% sure they were not facet injections. No relief from my lower back pain at all from any shot I have received so far which has been L4 & L5(twice) QL muscle shots. Greater Troc. shot. In my opinion – getting shots where the pain is but NOT getting the shots where the pain is starting from-that is the key right?? There could be a very good chance my pain is starting from the hip area/ medius/minimus area-just hard to say. Maybe the hip bursa area? I do remember getting a shot in that hip bursa area back in Mid Nov. 2015 due to that I think I had an inflamed Hip bursa and that shot took away all of my pain. I was Giddy up until first week of Jan. 2016. I did receive another shot mid Jan. 2016 in that same area and it did not work so very frustrated that none of these shots have given me pain relief in my lower back / left side of my leg. Again the pain is not always a 10 pain 100% of the time but it is there. Yesterday I was picking up leaves and my back felt very tight and it was hard for me to get my back into a straight position. I iced it later and that helped. I do take 800MG Advil when needed and that does seem to be every day and this has been going on since first week of Jan. 2016. New PT guy I think is going to make a difference but I need to get pain free to want to do PT without being in this pain. I understand that the pain is good for the PT person so that he can determine what to do based on that pain but I want to be able to function. My two cents is that because of my mild Scolisios I tend to keep my weight on my left side most of the time and this has caused the pain on my left side and my lower back? I do have an appt. with Dr. M. wed. April 6th for the next shot. Either Trans. Epidural or Facet and again the key take away is where should this shot go into my body. Dr. M is a spine guy so if this next shot from Dr. M. does NOT work then I will go back to my pain clinic guy and get a cortisone shot in my hip area(what else at that point can I do?) I do undertand that have I Dic. degeneration in my L4 & L 5 but hey- those shots in that area have not worked so maybe the shot should be higher up?? Thank You for your help & guidance. It means a lot !!
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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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